Abstract 608P
Background
Mucosal melanoma (MM) is a rare and aggressive subtype of melanoma arising from mucosal surfaces. While MMs are distinct from cutaneous melanomas (CMs) in pathogenesis, etiology and prognosis, management of both subtypes has remained largely similar, as the rarity of the disease poses a challenge to developing evidence-based clinical guidelines for MM. We performed a meta-analysis on the use of immune checkpoint inhibitors (ICIs) and targeted therapy for MM.
Methods
We searched five databases (PubMed, Cochrane, Embase, Web of Science and Google Scholar) for studies evaluating the efficacy of ICIs and targeted therapy in the treatment of locally advanced or metastatic MMs. After including only cohort and observational studies with available overall survival (OS) and progression free survival (PFS) data, the eligible studies comprised patients treated with anti-PD1, anti-CTLA4, VEGFR inhibitors or tyrosine kinase inhibitors (TKIs). For single-arm and double-arm studies that reported Kaplan-Meier curves, we digitally reconstructed individual patient data using Guyot's algorithm and calculated the OS, PFS and hazard ratios, along with the 95% confidence intervals.
Results
We included 26 studies with a total of 1911 participants. Our results show that combined anti-PD1 and anti-CTLA4 therapy had the highest 12-month OS and 12-month PFS at 0.677 (0.608,0.754) and 0.388 (0.316,0.475) respectively. This was followed by anti-PD1 therapy alone (OS: 0.602 (0.569,0.638); PFS: 0.282 (0.251,0.317)), anti-PD1 and VEGFR inhibitor combination therapy (OS: 0.506 (0.437,0.585)), TKI therapy (OS: 0.482 (0.376,0.618); PFS: 0.083 (0.037,0.187)) and anti-CTLA4 therapy alone (OS: 0.333 (0.284,0.391); PFS: 0.098 (0.059,0.165)). In the double-arm studies, anti-PD1 and anti-CTLA4 combination therapy had similar OS and PFS with anti-PD1 treatment alone (OS: HR 0.866 (0.616,1.22); PFS: HR 0.848 (0.666,1.08)), however, anti-PD1 therapy alone had significantly better PFS than anti-CTLA4 alone (HR 0.548 (0.376,0.799)).
Conclusions
Collectively, these results demonstrate that anti-PD1 and anti-CTLA4 combination therapy has the most favorable outcome in the treatment of MM, while anti-PD1 therapy is the single best agent.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
163P - Chemotherapy versus palliative radiotherapy in advanced inoperable gall bladder cancer
Presenter: Vimal Sekar
Session: Poster Display
Resources:
Abstract
164P - Neoadjuvant immune checkpoints inhibitors plus chemoradiotherapy for patients with locally advanced esophageal squamous cell carcinoma
Presenter: Ming-Wei Kao
Session: Poster Display
Resources:
Abstract
165P - BMI impact on the prognosis of unresectable HCC patients receiving first-line lenvatinib or atezolizumab plus bevacizumab
Presenter: Elisabeth Amadeo
Session: Poster Display
Resources:
Abstract
166P - Preoperative risk factors strongly related to early recurrence after R0 resection of gallbladder cancer
Presenter: SANGHUN LEE
Session: Poster Display
Resources:
Abstract
167P - Peripheral blood neutrophil-to-lymphocyte ratio correlated with serum IL-8 level and predict the outcome of hepatocellular carcinoma patients treated with immune-targeted combination therapy
Presenter: Xuenan Peng
Session: Poster Display
Resources:
Abstract
168P - Real-world clinicopathological characteristics and treatment patterns of esophageal cancer patients in China
Presenter: Zhihao Lu
Session: Poster Display
Resources:
Abstract
169P - Conversion response and prognostic factors in HCC patients with macrovascular invasion treated with atezolizumab plus bevacizumab
Presenter: xiaodong Zhu
Session: Poster Display
Resources:
Abstract
170P - Atezolizumab plus bevacizumab (A+B) versus lenvatinib for BCLC-B stage of patients with hepatocellular carcinoma (HCC): A large real-life worldwide population
Presenter: Francesco Vitiello
Session: Poster Display
Resources:
Abstract
171P - Retrospective study of the correlation between proteinuria and renal function in patients (pts) with unresectable hepatocellular carcinoma (uHCC) treated with atezolizumab plus bevacizumab (Atezo+Bev): ARISE study
Presenter: Kazuomi Ueshima
Session: Poster Display
Resources:
Abstract
172P - Trastuzumab deruxtecan (T-DXd) in Chinese patients (pts) with previously treated HER2-positive locally advanced/metastatic gastric cancer (GC) or gastroesophageal junction adenocarcinoma (GEJA): Primary efficacy and safety from the phase II single-arm DESTINY-Gastric06 (DG06) trial
Presenter: Zhi Peng
Session: Poster Display
Resources:
Abstract